Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample

Abstract

BackgroundA large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources.PurposeThe major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort.MethodsThe cohort consisted of 484 men and 497 women, aged 45–69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms.ResultsA total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD, p = 0.003), self-esteem (HR 0.64, p = 0.004), and sense of coherence (HR 0.70, p = 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46, p = 0.014), hopelessness (HR 1.59, p = 0.003), and depressive symptoms (HR 1.45, p = 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67, p = 0.034), self-esteem (HR 0.69, p = 0.048), and hopelessness (HR 1.48, p = 0.023).ConclusionsThe psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.

Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases

“…Other studies confirm that high self-esteem may be associated with a lower frequency of coronary diseases 20 and improved quality of life among patients with heart failure 25 . Positive psychological conditions, such as high self-esteem, may protect the heart, preventing systemic inflammation and atherosclerosis, in contrast with negative psychological conditions, such as depression and despair 24 .…”

“…One in every five patients presented high levels of depression three months after an episode of myocardial infarction; this mood disorder is associated with increased risk of new cardiovascular event or death 19 . Other studies provide evidence that depression can raise the level of mortality among patients with coronary diseases 15 , 20 .…”

Confrontation as a Mediator between Sense of Coherence and Self-management Behaviors among Elderly Patients with Coronary Heart Disease in North China

“…This may be explained by the similar characteristics of CHD and Type 2 diabetes in terms of their close association with lifestyle and influence on patients' psychological well-being. SOC has been found to be linked with a reduced risk of CHD and serve as important psychological resource for elderly patients with CHD [29]. In the SM, Antonovsky indicates that SOC can induce patterns of responses to situations that stimulate one's brain to send messages to activate appropriate bodily resources and make one realize the necessity to cope both instrumentally and emotionally [15].…”

Effect of Hospital-based Cardiac Rehabilitation on Quality of Life and Physical Capacity in Acute Myocardial Infarction Patients: 2 Years Follow Up

“…Therefore, we are unable to pool the data to quantify the effect. As reported in previous studies [15,29], patients with AMI initially felt hopelessness and fear, and psychological interventions played an important role in the success of CR. Improving the mental component of QOL is very important, because psychological anxiety of the patient is closely related to motivation and compliance of treatment and eventually affects prognosis [30].…”